剖宫产瘢痕憩室对宫腔内人工授精妊娠结局的影响  

Effect of cesarean scar diverticulum on pregnancy outcome of intrauterine insemination

作　　者：习艳霞[1] 王慧春[1] 刘慧文[1] XI Yan-Xia;WANG Hui-Chun;LIU Hui-Wen(Reproductive Center,Maternal and Child Health Care Hospital of Haidian District,Beijing,100080,China)

机构地区：[1]北京市海淀区妇幼保健院生殖中心,北京100080

出　　处：《中国妇幼保健》2020年第21期4060-4063,共4页Maternal and Child Health Care of China

摘　　要：目的探讨剖宫产后子宫瘢痕憩室对人工授精(IUI)妊娠结局的影响。方法回顾性分析行IUI助孕的剖宫产术后瘢痕子宫患者218例共520个周期,其中瘢痕憩室组患者54例共139个IUI周期,非瘢痕憩室组患者164例381个IUI周期,按年龄匹配随机选取同期行IUI的非瘢痕子宫患者218例517个周期为对照。比较瘢痕子宫患者与非瘢痕子宫患者IUI妊娠率,比较瘢痕憩室组、非瘢痕憩室组及非瘢痕子宫组3组间IUI妊娠率,比较瘢痕憩室修复术后患者与未行修复术患者IUI妊娠率。结果瘢痕子宫组与非瘢痕子宫组的IUI周期妊娠率、累积妊娠率及自然流产率差异均无统计学意义(P>0.05)。瘢痕憩室组的IUI周期妊娠率和累积妊娠率均显著低于非瘢痕憩室组和非瘢痕子宫组(P<0.05)。3组之间自然流产率差异无统计学意义(P>0.05)。瘢痕憩室修复术后患者的IUI周期妊娠率和累积妊娠率高于未行修复术患者,但差异无统计学意义(P> 0.05)。结论剖宫产瘢痕憩室可显著降低患者的IUI周期妊娠率和累积妊娠率,但不影响自然流产率。瘢痕憩室修复手术对IUI的妊娠率影响不大,有待积累样本量后进一步分析。Objective To explore the effect of cesarean scar diverticulum after cesarean section on pregnancy outcome of intrauterine insemination(IUI).Methods A total of 520 IUI cycles in 218 patients with scarred uterus after cesarean section were retrospectively analyzed,including 139 IUI cycles in 54 patients with cesarean scar diverticulum and 381 IUI cycles in 164 patients without cesarean scar diverticulum.A total of 517 IUI cycles in 218 age-matched patients without scarred uterus were selected as control group.IUI pregnancy rates in scarred uterus group and non-scarred uterus group were compared.IUI pregnancy rates in cesarean scar diverticulum group,non-cesarean scar diverticulum group,and non-scarred uterus group were compared.IUI pregnancy rates in patients undergoing cesarean scar diverticulum surgery and patients not undergoing cesarean scar diverticulum surgery were compared.Results There was no statistically significant difference in IUI cycle pregnancy rate,cumulative pregnancy rate,and spontaneous abortion rate between scarred uterus group and non-scarred uterus group(P>0.05).IUI cycle pregnancy rate and cumulative pregnancy rate in cesarean scar diverticulum group were statistically significantly lower than those in non-cesarean scar diverticulum group and non-scarred uterus group(P<0.05).There was no statistically significant difference in spontaneous abortion rate among the three groups(P>0.05).IUI cycle pregnancy rate and cumulative pregnancy rate in patients undergoing cesarean scar diverticulum surgery were statistically significantly higher than those in patients not undergoing cesarean scar diverticulum surgery(P>0.05).Conclusion Cesarean scar diverticulum can significantly reduce IUI cycle pregnancy rate and cumulative pregnancy rate,but it does not affect spontaneous abortion rate.Cesarean scar diverticulum surgery has little impact on pregnancy rate of IUI,further analysis needs accumulation of samples.

关 键 词：宫腔内人工授精 剖宫产术 剖宫产瘢痕憩室 妊娠率 

分 类 号：R719.8[医药卫生—妇产科学]